Hi, this is Tom, and in this episode I'm going to be going through nephrotic syndrome.

And you can find notes at zero to finals.com and in the zero to finals pediatrics book.

And you can find flashcards and questions at members.0.0 tofinals.com.

And at the end of the episode, we'll go through some questions so you can test yourself on what you just heard. So let's jump straight in. Nephrodic

syndrome involves a large amount of protein being lost in the urine. The basement membrane in the

glomerulus becomes highly permeable to protein,

allowing proteins to leak from the blood into the urine. It's most common between the ages of

two and five years. Let's talk about the features. Frothy urine and generalized edema are the key presenting features.

Nephotic syndrome involves the classic triad of protein urea with more than 3 plus of protein

on a urine dipstick,

hypoalbuminemia, which is a low serum albumin level,

and edema affecting the face, the legs,

or generalized across the whole body.

Other important features are hyperlipidemia with increased cholesterol and triglycerides produced by the liver, high blood pressure due to activation of the renin-angiotensin

aldosterone system and sodium retention, and hypercoagulability with an increased tendency to form blood clots.

Let's talk about the causes. Minimal change disease causes over 90% of cases of nephotic syndrome in

children under 10.

Nephotic syndrome may be associated with intrinsic kidney disease, specifically

focal segmental glomerulis sclerosis or membranoporoperative glomerulenephytis.

It can be secondary to an underlying systemic illness, such as H.Noxonline Pura, or H.S.P.

Diabetic nephropathy, although this is uncommon in young children.

Infection, for example, HIV, hepatitis or malaria, and malignancy,

...